FarzadMostashari, M.D.FarzadMostashari, M.D., national coordinator for health information technology, began the meeting by noting that the committee’s challenge is to “keep its eyes on the prize and feet on the ground.” By that he meant it has to work within the dynamic tension between maintaining momentum toward its health IT goals and meeting providers where they are. “The onramp has to be feasible for new groups just now implementing systems,” he added. “It has to be something they feel they can do. But we also must keep in mind where we need to be by the time 2016 rolls around.”He said ONC also has been made keenly aware that it has an obligation to support larger health care transformation goals involving payment reform and patient-centered quality improvements. “We have to frame this so that no hospital CIO has to make a choice between accountable care and meaningful use,” Mostashari said. “We should make meaningful use the roadmap they follow.”In its proposals, the MU Work Group wants Stage 2 to maintain momentum in the breadth of uses of electronic health records. Among the new measures proposed to the larger HIT Policy Committee for consideration are:• For hospitals, 10 percent of patients/families can view and download relevant information about a hospital admission; information available for all patients within 36 hours of the encounter.• 30 percent of provider visits have at least one electronic provider note and 30 percent of eligible hospital patient days have at least one electronic note.• Hospital medication orders are automatically tracked via electronic medication administration record (in-use in at least one hospital ward/unit).• For providers, patients are offered secure messaging online and more than 25 patients have sent secure messages online.• Ten percent of patients have a list of care team members (unstructured data for Stage 2).On the question of the timing of Stage 2, the work group is suggesting that the Policy Committee consider recommending one of three options to CMS:1. Maintain current timeline and one-year EHR reporting period; or2. Maintain current timeline and permit 90-day EHR reportingperiod; or3. Delay the transition from Stage 1 to Stage 2 by one year (affects only providers who begin meaningful use program in 2011).
